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  • Influence of Gender on Outcomes after Anterior Cervical Discectomy and Fusion

    Final Number:

    Parth Kothari BS; Jeremy Steinberger MD; Nathan John Lee BS; Branko Skovrlj MD; Dante Leven DO; Javier Z Guzman BS; John I Shin BS; John M. Caridi MD; Samuel K Cho

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2015 Annual Meeting

    Introduction: Gender may have an effect on outcomes. Large scale studies examining the effect on gender on outcomes after anterior cervical discectomy and fusions (ACDF) have not been performed to date.

    Methods: Adults (> 18 years) undergoing ACDF from 2005-2012 were identified using the Current Procedural Terminology (CPT) codes in the ACS NSQIP database. Patients were divided by gender. Baseline, operative, and outcomes data were compared in bivariate fashion. Univariate and multivariate analyses were performed to assess the impact of gender on 30-day postoperative complications and mortality.

    Results: 3,845 patients were identified, of which 49.7% were women. Females were more likely to have preoperative dyspnea (8.06% vs 5.48%, p=0.0015). Males were more likely to have American Society of Anesthesiologists (ASA) physical status classification scores greater than or equal to 3 (39.25% vs 35.22%, p=0.0098), increased likelihood to consume greater than two drinks per day in the two weeks prior to admission (5.07% vs 1.26%, p<0.0001), and higher overall cardiac comorbidities (47.05% to 42.07%, p=0.0019). Intraoperatively, males had increased operative time more than four hours (7.5% vs 5.6%, p=0.0174), but rate of intraoperative complications, return to the operating room, overall postoperative morbidities, and mortality were not statistically different between males and females on univariate and multivariate analyses.

    Conclusions: In evaluating gender differences in patients undergoing ACDF, intraoperative complications, thirty-day morbidity, and mortality were not statistically different between genders.

    Patient Care: Understanding the relationship between gender and surgical outcomes after ACDF is important for provider understanding and bettering patient care.

    Learning Objectives: By the end of this presentation, participants should be able to assess the effect of gender on 30-day outcomes after ACDF.


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